What is Health?

It’s now been over 1.5 years since the COVID-19 virus spread its way out of China and across the world, creating a global pandemic that has brought our human world close to a full stop. This unprecedented infectious virus was bigger, faster, wider spread, and deadlier than any of the epidemics the global population has experienced over the last 100 years. Millions of people across the planet, regardless of gender, color, ethnicity, race, wealth, religion, politics, etc., have been infected, resulting in over 600,000 deaths in the U.S. alone, and millions worldwide. In March 2020, it was clear to everyone that in order to stop the voracious spread, the global population had to go into quarantine. We were all stuck inside for months. The global economy plummeted, travel halted, movement in public spaces was restricted, jobs were lost, trade decreased, and fear amongst the populace grew. The impact on all humans has been devastating. At times, it has felt nearly impossible or hopeless that we could find solutions quickly enough to significantly decrease the spread of COVID-19 and lower mortality rates.

Yet, through tireless effort, steadfast commitment, and perseverance, the global scientific community was able to develop vaccines that could finally bring us hope of returning back to life, outside of quarantine. It’s important though to not get too cavalier. We still have a long way to go in protecting all people on the planet. This has been a horrendously deadly circumstance to remind people that in human life, nothing, and I mean this in no uncertain terms, is more important than our health, individually and collectively. Without health, we have painfully witnessed that all our lives can come to a complete stop, one way or another.

So how should we work on improving our health? What is the definition of health? What is considered healthy? These very broad questions have very broad answers. Every day, we are under a constant barrage of information or misinformation of what we need to do to maintain health. There is not one single measure, approach, or qualification that defines good health. There is not a one-size-fits-all program, and good health is not just a matter of responsible behavior and self-accountability. In many cases, there are circumstances where people are predisposed to certain genetic disorders that we cannot unwrite, at least at the moment. There are also a host of external factors that impact our health—environment, war, climate, violence, social determinants, economics, food security, political stability—that many populations have little to no control over. Furthermore, health does not operate or exist in a vacuum. Health systems are pivotal in the role of treating, delivering, and maintaining public and individual health. If we were to measure and assess the overall ‘health’ of the global human population, we should start by learning and analyzing the latest information of global burden of disease and causes of death. It is critical for us to review and understand what has happened if we are to improve what may be.

The Institute for Health Metrics and Evaluation (IHME) led the study and development of the Global Burden Disease Report (GBD), considered to be one of largest and most comprehensive systematic efforts to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors from 2000-2019. According to The Lancet medical journal, the GBD produced estimates of incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. In the GBD, the results determined the following top 10 global causes of death in 2019:

  1. Ischaemic heart disease

  2. Stroke

  3. Chronic obstructive pulmonary disease

  4. Lower respiratory infections

  5. Neonatal conditions

  6. Trachea, bronchus, lung cancers

  7. Alzheimer disease and other dementias

  8. Diarrhoeal diseases

  9. Diabetes mellitus

  10. Kidney diseases

Per the World Health Organization (WHO)’s summary analysis, 7 of the 10 leading causes of deaths in 2019 were noncommunicable diseases (NCD). These seven causes accounted for 44% of all deaths or 80% of the top 10. However, all noncommunicable diseases together accounted for 74% of deaths globally in 2019. Noncommunicable diseases, also known as chronic diseases, are not spread human-to-human. They are a result of a combination of genetic, physiological, environmental and behavioral factors. In other words, people all over the world are mainly dying from non-infectious, chronic conditions, many of which do not have an end or cure. This includes heart attacks, strokes, cancers, chronic respiratory conditions, diabetes, and mental health disorders and conditions. These factors set the scene of the state of global health prior to COVID-19. As the coronavirus expanded with brute force across the globe, all eyes were focused on finding solutions to decrease the spread and to save the lives of those infected with the virus. From the onset of COVID-19 to the current period, there have been 175,987,176 (176M) confirmed cases of COVID-19, including 3.81M deaths, as reported by the WHO. And the count continues, while simultaneous actions worldwide are underway to deliver vaccinations to as many people, who can receive the vaccination, as possible. It’s too soon to tell what kind of numbers we will see within a year or two of COVID-related infections. However, even though there a number of cases of healthy people infected by COVID, the medical community has concluded that people, who have prior underlying health conditions and/or lower socio-economic status, are much more susceptible to contracting the virus and experience greater difficulty in mitigating the effects of the virus. Many of those underlying conditions, which are further exacerbated in poorer communities, are the chronic diseases mentioned above. Per the GBD, in 2019, the key facts included:

  1. Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally.

  2. Each year, more than 15 million people die from a NCD between the ages of 30 and 69 years; 85% of these "premature" deaths occur in low- and middle-income countries (LMICs)..

  3. 77% of all NCD deaths are in LMICs.

  4. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million).

  5. These four groups of diseases account for over 80% of all premature NCD deaths.

  6. Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from a NCD.

  7. Detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs.

So what does all of this mean? Why are these facts important to the general population? If human survival is still important for people, particularly future generations, then we need to address the main conditions causing human mortality. Moreover, we need to make our overall health the highest priority for the global population. We need people, countries, systems, organizations, and policies in place to work on solutions for this multi-faceted challenge. Health, in this case, not only relates to physical examinations, but also relates to mental health, emotional health, food security, socio-economic status, race, environment, climate, access to healthcare, maternal and child health (MCH), education, high-risk lifestyle (smoking, drug use, alcohol, etc), inequality, public and personal safety, public health protection, public policies, and much more. It will truly take a village to find solutions for lessening the global burden of disease.

Our mission with BoldFit is to be an active player in the improvement of our clients’ health and lifestyles. We base our programming on scientific and evidence-based results for health and fitness. Yes, science is imperfect, but one of the most important aspects of the scientific method is repeatability. Per the The Scientific Method: A Need for Something Better? article in the American Journal of Neuroradiology, the experiments performed to prove a working hypothesis must clearly record all details so that others may replicate them and eventually allow the hypothesis to become widely accepted. Many of us are very aware how much misinformation noise exists in our world, telling people what to eat, how to exercise, what to avoid, which products to buy, and selling non-evidenced based solutions for a number of health-related concerns for the sake of pure profit. Social media has only increasingly exacerbated the flow of health misinformation. Instagram ‘influencers’ have become the health experts over medical/health specialists and hard science. It is very easy to believe in the information passed around and it is harder to take the time to really research the topic and find evidence-based results that support the informant’s statements. Not all the information is wrong or bad. Social media and other platforms have played a huge role in providing access to information and connecting people anywhere and nearly everywhere to experts, specialists, studies, journals, presentations, clinics, discussions, etc.

Yet, if we all have a role to improve health outcomes, then it is incumbent on those of us who take any and every aspect of health seriously to help filter the noise. This requires work and effort. Anyone can use an app to modify a selfie and create a ‘perfect body,’ without much effort. And, spending hours obsessing over how great you look in a picture is not effort. Outside of those technological filters, we need to perform actions throughout our entire life to avoid, or at least lessen as much as humanly possible, the leading causes of death and to work on the enhancement of our quality of life. What does that mean in terms of ‘health?’ Many things, such as reducing stress, living in a safe environment, accessing healthy food options, accessing healthcare, developing and maintaining greater and more sustainable mobility, supporting local communities, destigmatizing mental health disorders, mitigating climate change, accepting people as people, increasing strength, understanding the power of our mind, spreading kindness and civility, and the list can go on, indefinitely.

We, most likely, will never live in a ‘perfect w0rld.’ However, if we are to endure our human existence on this planet, and we have the capability to do so, health has to be the foundation for everything that we encounter in our own daily lives and in the world around us. If we have learned anything from COVID-19 is that threats to human existence are still out there and will continue to arise. Are we better prepared to face those challenges? Are we taking the appropriate measures to put safeguards and preventative measures in place? In the event of another health crisis, will we be able to save more lives? We simply cannot afford to battle against threats from a reactive position. In order for us to be proactive, we must consider the improvement of global health, and the way down to individual health, a priority for living a safer and more productive life.